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ลอง 'Dry January' ไหม สิ่งที่ควรรู้เกี่ยวกับแอปที่อ้างว่าช่วยได้

On New Year’s Day, many people will kick off Dry January, when they’ll try to go a month without consuming alcohol, or at least drinking less.

As we’ve done with many things this pandemic year, including talking to friends and working, many are turning to apps and online tools for help.

Search “Dry January” in the Apple App Store, and you’ll get half a dozen apps that say they can help. Related searches for “reduce drinking” or “drink less” will bring up several more. But not every app is created equal.

Some apps have been developed by health organizations that rely on science-backed practices. Others come from unknown developers with language or techniques that can discourage someone who is trying to change their relationship with alcohol.

“It’s not just the fact that this app doesn’t help them stop drinking,” David Crane, a tech worker-turned behavioral science and health researcher, who has studied the efficacy of drinking reduction apps, said. “If this person thinks ‘I can’t stop drinking, this app was really great, I’m the thing that’s at fault’ — which is a false assumption — then it may take them ages before they make another attempt.”

If you are considering doing Dry January with the help of your smartphone, there are a few things —especially in a pandemic year when depression, anxiety, and substance use is on the rise — you should know.

Who Dry January is (and isn’t) for

The first is that Dry January isn’t for everybody. Alcohol Use Disorder is what’s known as a “spectrum disorder,” which means it can range from mild to severe (you can learn more about that here). First and foremost, people with a severe alcohol use disorder should not quit alcohol without the help of a professional, because alcohol withdrawal can have serious consequences, including death.

For the rest of the population, there are a range of uses, benefits, and even downsides of Dry January. The British organization Alcohol Change UK, which runs a national Dry January campaign, has undertaken studies that show a host of health benefits — from weight loss to reduced drinking down the line — related to quitting alcohol for just 30 days. For people who may or may not fall on the alcohol use disorder spectrum, experts see it as a way to reflect and reset.

“There are a lot of benefits from taking a break from alcohol,” Dr. George Koob, the director of the National Institute on Alcohol Abuse and Alcoholism, said. “If it’s done wisely, it gives you a chance to evaluate your relationship with alcohol and cultivate other ways of relaxing and socializing coping.”

However, if sustainable behavior change is the goal, cutting something out entirely might not be the way to go for everyone.

“These temporary programs need to be used with caution,” Nir Eyal, the author of Indistractable and former Stanford University lecturer in behavioral design, said. “The problem is, if it’s about abstinence, and restriction, and sacrifice — like oh it’s gonna be so hard to ‘give up drinking,’ like I’m denying myself — you’re gonna bounce back like a rubber band.”

Instead, Eyal recommends a more gradual approach to behavior change. That theory is reflected in the recent trend of “Dry-ish January,” in which people pledge to reduce, not abstain.

That brings us to the first thing to consider when looking at alcohol behavior change apps: What is your goal?

Dry vs. Dry-ish

People participate in Dry January for different reasons, including to lose weight or re-examine their relationship with alcohol. Some want to experiment by cutting back on alcohol rather than quitting it entirely.

This trend, also called “Moist January” (sorry), is an area where apps have a lot of potential.

“Without technology, previous solutions have been all or nothing,” Eyal said. “Like, I’m either out of control, or sober. And I think what app-enabled technologies now allow us to do is allow people to moderate their use in ways that weren’t really possible because we didn’t have that instant connection in the same way that we do now.”

Multiple apps fall into the category of drink trackers. If you’re not drinking at all, this is a fairly useless feature. But becoming more conscious of the amount you drink is an important first step to reduction, if that is your goal. In a 2015 study of alcohol behavior change apps, Crane said that he and his co-researchers found that “the things that seemed to work best are things such as self monitoring, and feedback. Even just noticing or even just thinking about alcohol consuming, typically reduces the amount that you drink.”

Apps, of course, aren’t the only way to begin tracking and moderating. Koob recommends exploring the NIAAA’s “Rethinking Drinking” portal, which contains resources and tips for understanding your own level of alcohol use, and for cutting back. That includes strategies for tracking and goal setting, but also guides users on where to find additional support, whether from a physician or a group.

What apps can do is automate some of the tracking process, and provide instantaneous feedback. They can help users visualize their success, like with calculations of the amount of money saved by not drinking, and calendars marked with days, weeks, or months where users stuck to their goal.

Crane designed an app called Drink Less that emphasizes this strategy and other behavior change techniques (unfortunately, it’s a UK-based app and is not available in the U.S.). Eyal recently invested in a “mindful drinking” app called Cutback Coach, in which users track their alcohol consumption by texting a bot the emoji of their drink, when they have it.

Eyal says the app has potential because when it’s easier to track drinks, it’s easier to pay attention to how much you’re drinking.

And while maybe not with emoji, most other drinking reduction apps help users track their drinks. Some highly rated ones, according to app store reviews, are Drink Control, Drinker’s Helper, DrinkCoach+, and Less.

“Backed by science”

Experts say reviews that let you see what works for other people are one of the best ways to select a quality drinking reduction or cessation app.

“I have to give the trite advice of ‘check the reviews,’” Eyal said. “Unfortunately we don’t have much more than that, at this point. I wish we did.”

That’s because there is not a wide variety of apps to choose from, nor is there an independent, trusted source that rates the quality and efficacy of apps. Experts say Google and Apple need to do more to prevent people from “wasting their time and damaging their self confidence” with poorly designed apps on their platforms, Crane said.

Prior research has shown that the scientific quality and effectiveness of these apps can vary widely.

“There are a whole herd of studies now on the effectiveness of what you call e-interventions and and utilization of apps for alcohol reduction,” Koob said. “Most of them show some benefit in about 60 percent of them but, but by no means, you know, is it overwhelming at this point.”

However, there are some things you can look for.

Most important is whether the app explicitly contains references to evidence-backed behavior change methods, something that Less, Drinker’s Helper, and Alcohol Change UK’s app, Try Dry, do in their app store and website descriptions.

Of course, as Eyal said, “anybody can say ‘backed by science’” — the app stores don’t require proof of these claims. But Crane says that it can still be a powerful indicator.

“There’s been a ton of research on how to help people go without alcohol,” Crane said. “There’s been some really, really smart people who devote careers to this, and the answers they’ve come up with can help change behavior. So the apps that look to that, that go ‘this is what the smart people say, and we’re going to interpret it for you, our job is to package it in a form that you like using’ are the ones that people should trust more.”

While looking for keywords such as “science” or “evidence-backed” is important, you should also consider the app maker. Try Dry doesn’t have the best reviews, but it does come from the official charity that runs the Dry January health campaign in the UK. Drinker’s Helper and Less are both made by companies with extensive and informative websites. Less’s maker, Big Sky Health, has leadership with medical expertise. Drinker’s Helper says it’s “an app built by people who quit drinking to help others stop drinking alcohol or moderate their drinking.” In contrast, many of the other apps are made by individuals or app-contracting companies. As ever, consider the source.

Other features to look for

Once you’ve checked for evidence-based methods, and decided the app makers aren’t sketchy, selecting the right app comes down to your personal preferences and goals. The basic features most of these apps include are: positive feedback (like how much money you’ve saved), drink tracking (if you’re looking to cut down, not quit), and tracking sober days. But some apps go beyond.

For example, Less taps its expert panel to provide articles and other content to support your goals. Drinker’s Helper has mindfulness exercises and virtual, anonymous support groups. Unfortunately, those Drinker’s Helper features only come with a premium subscription, which is another thing to look out for: What does the app cost?

Most of these apps are free, but as with Drinker’s Helper, some have subscription tiers. The DrinkCoach+ app is free, but its unique service — which is connecting users with professional, trained alcohol reduction coaches over video chat — costs £55 per session.

There are also apps with fewer bells and whistles. Sobriety Tracker counts sobriety (of any kind — the user can specify what they’re abstaining from) down to the second. It also has a community forum.

Mostly, if you’re looking for an app to help with Dry January, Dry-ish January, or to moderate or stop drinking long term (in which case you may want to seek professional help), the process will likely be one of trial and error. Whether for weight loss reasons or to change your relationship with alcohol, you should know that the “error” part is more than OK.

Which is why Crane’s advice boils down to “if at first you don’t succeed, try again.”

“You’ve got to understand that this usually takes multiple attempts,” Crane said. “Hardly anybody gets it the first time, and there isn’t really a lot of benefit to getting your first time anyway. You kind of want to go this a few times so you can learn the lessons, and then use those lessons for other health behavior changes you want to make. Use this as a springboard, take your time, and keep going.”

If you are struggling with alcohol, you can find help by visiting the website of the Substance Abuse and Mental Health Services Administration or by calling the National Helpline at 1-800-662-HELP (4357).

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